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Emergency hospital admissions in patients from care home settings

Dataset
Version: 1.0.0
Longitudinal routine data for 128,000 admissions to hospital as an emergency from a care home; including treatments, interventions, ITU admissions and outcomes. Deeply phenotyped longitudinal data including serial physiology, blood biomarkers.

Summary

Citation:
Emergency hospital admissions in patients from care home settings

Documentation

Description:
Nearly 340,000 older people in England live in residential or nursing care homes. Older people living in care homes often have complex health problems which make them more likely to need hospital care in hospital if their health suddenly deteriorates. People living in care homes account for 185,000 emergency admissions to hospital each year and spend over 1.46 million days in hospital beds. Improving care for older patients living in care homes will directly benefit patients while reducing the demand for hospital beds and reduce the risk of hospital overcrowding. A significant proportion of hospital admissions from care homes are unnecessary and could be avoided if their needs were addressed differently. The hospital environment and can be distressing for some older people living in care homes and the burden of transferring patients from their home to hospital can be significant. These factors have driven a search for alternative ways of providing better care. This highly granular dataset of 128,000 admissions from care home provides a unique opportunity to understand reasons, pathways and outcomes from acute presentations to hospital. PIONEER geography: The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. Electronic Heath Record. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. Scope: Acute care episodes amongst patients aged over 65 from care homes. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics, co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, admissions, wards), presenting complaint, physiology readings (heart rate, BMI, blood pressure, respiratory rate, NEWS2 score, oxygen saturations and clinical frailty scale), Charlson comorbidity index, Lab analysis results(e.g. urea, albumin, platelets, white blood cells) microbiology results, procedures, outpatients admissions, oxygen delivery methods, drug administered and all outcomes. Linked images available (radiographs, CT scans, MRI). Available supplementary data: Matched controls; ambulance, OMOP data, synthetic data. Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.
Is Part Of:
NOT APPLICABLE

Coverage

Spatial:
United Kingdom, England, West Midlands
Typical Age Range:
65-110
Follow Up:
OTHER
Physical Sample Availability:
NOT AVAILABLE
Pathway:
Data is representative of the multi-ethnicity population within the West Midlands (42% non white). Data includes all patients admitted during this timeframe, with National data Opt Outs applied, and therefore is representative of admissions to secondary care. Data focuses on in-patient stay in hospital during the acute episode but can be supplemented on request to include previous and subsequent hospital contacts (including outpatient appointments) and ambulance, 111, 999 data.

Provenance

Origin

Purposes:
CARE
Sources:
EPR
Collection Situations:
ACCIDENT AND EMERGENCY

Temporal

Accrual Periodicity:
QUARTERLY
Distribution Release Date:
2021-11-24
Start Date:
2018-01-01
End Date:
2021-08-01
Time Lag:
OTHER

Accessibility

Access

Access Service:
Trusted Research Environments (TRE) are built using Microsoft Azure services and hosted in the UK to provide research teams a safe, secure and agile environment which allows users to quickly analyse, interpret and form an enriched view of primary care information through a range of integrated datasets. Health data collated from multiple sources is ingested into a secure data lake which will then allow subsets of data to be made available to research teams on approval of a data request. Once approved a customer specific TRE is made available with a standard set of leading analytical tools from Microsoft including Azure Databricks, Azure Machine Learning, Azure SQL and Azure Synapse (for large-scale data warehouses). Specific tools can be provided at an additional cost over the standard platform data access charge and the PIONEER team will work with you to determine your exact needs. Access to the TRE is managed using the latest virtual desktop technology to provide a safe and secure end-user experience. By utilising leading edge design PIONEER are able to create TREs rapidly to enable us to service any customer requirement.
Access Request Cost:
www.pioneerdatahub.co.uk/data/data-services-costs/
Delivery Lead Time:
1-2 MONTHS
Jurisdictions:
GB-ENG
Data Controller:
University Hospitals Birmingham NHS Foundation Trust
Data Processor:
NOT APPLICABLE

Usage

Data Use Limitations:
GENERAL RESEARCH USE
Data Use Requirements:
PROJECT SPECIFIC RESTRICTIONS
Resource Creators:
  • This publication uses data from PIONEER
  • an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)

Format and Standards

Vocabulary Encoding Schemes:
  • ICD10
  • OPCS4
  • SNOMED CT
Conforms To:
LOCAL
Languages:
en
Formats:
SQL

Enrichment and Linkage

Derivations:
Not Available

Observations

Statistical Population
Population Description
Population Size
Measured Property
Observation Date
Events
128,076 acute episodes amongst patients aged over 65 with identifiable features of frailty between 01/01/2018 and 01/08/2021
128076
Count
2021-11-24